There’s a lot of talk about the narcissistic spectrum — the idea that narcissism runs on a spectrum from “normal” narcissism (healthy self esteem) all the way through malignant narcissism at the top. Somewhere in the middle, “normal” or “healthy” narcissism shades into Narcissistic Personality Disorder (NPD).

While I do think narcissism runs on a spectrum, I don’t think “healthy” narcissism has much, if anything, to do with pathological narcissism. Healthy narcissism is what makes us stand up for ourselves when we are being attacked. Healthy narcissism is what makes us feel proud of ourselves when we’ve accomplished something good. Healthy narcissism is what makes us want to look our best when we’re going on a date.

People who are narcissists, on the other hand, have little to no self-esteem. They either hate who they really are, or they don’t know who they really are, so they develop a false self to stand in for their real one. The false self can only survive by feeding off the reactions of others (narcissistic supply). That’s why narcissists can be so manipulative and dangerous. Since they are usually in their “false self,” and can’t risk exposure of their vulnerable real one, they will go to extreme measures to keep their false self intact, which includes projecting any bad traits onto others, denial, lying, gaslighting, and other tactics meant to deflect attention away from any flaws and transfer them onto others.

To a narcissist, you are not a real person, since a false self can’t acknowledge your humanity, only your usefulness to them. Like an infant who hasn’t yet realized they are a separate entity from their mother, your only purpose is to serve them and keep them alive. Narcissists, like babies, are emotionally unable to recognize that you are a human being who has needs and desires of your own.

You can be a pathological narcissist without being a malignant one, though. Malignant narcissism isn’t a person with NPD who is “more” narcissistic; it’s a person who has both Narcissistic and Antisocial Personality Disorder (ASPD)or an NPD with ASPD or sociopathic/psychopathic traits. Malignant narcissists are very dangerous because they combine the traits of narcissism with the traits of a sociopath or psychopath.

From Wikipedia:

The APA’s Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM IV-TR), defines antisocial personality disorder (Cluster B):[19]

A) A pervasive pattern of disregard for and violation of the rights of others, occurring since age 15 years, as indicated by three or more of the following:
–failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest;
–deception, as indicated by repeatedly lying, use of aliases, or conning others for personal profit or pleasure;
–impulsivity or failure to plan ahead;
–irritability and aggressiveness, as indicated by repeated physical fights or assaults;
–reckless disregard for safety of self or others;
–consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations;
–lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another.
C) There is evidence of conduct disorder with onset before age 15 years.
D) The occurrence of antisocial behavior is not exclusively during the course of schizophrenia or a manic episode.
Antisocial Personality Disorder (ASPD) falls under the dramatic/erratic cluster of personality disorders, the so-called “Cluster B.”

I probably don’t need to define NPD here, since so much of this blog is about that.  While several of the traits of NPD and ASPD overlap (lack of empathy, aggression, and dishonesty), there are some differences too.   Conscience isn’t entirely lacking in a narcissist (though empathy, which is different from conscience, probably is).  In fact, some narcissists are overly concerned with “right” and “wrong” (of course, they’re always right) and never do anything remotely illegal and may seem concerned about “morals.”   That’s why so many of them are so judgmental and they can so commonly be found in churches and the helping professions.   Narcissists are also over-sensitive to criticism and care very much what others think of them, since the mask they wear requires the approval or at least attention of others.   People with ASPD and psychopaths (the latter are merely people who were probably born without a conscience or the ability to feel empathy) have no need for narcissistic supply from others since they aren’t wearing a mask.     They just want to do what they want to do and don’t care what you think of them.   They are not what anyone would call “sensitive” but most narcissists are incredibly sensitive (about themselves).   Unlike narcissists, who have strong emotions which are hidden due to shame, people with ASPD seem to not have any emotions, or their emotions seem limited to anger or boredom.    People with ASPD are also much more impulsive than narcissists, and don’t plan their actions ahead of time.  They act on whim, according to whatever strikes their fancy at the time.   They are also much more likely than people with NPD to break the law and be incarcerated (so there are a lot more narcissists walking around than antisocial people, which makes them more dangerous).

Malignant narcissists are a deadly combination of antisocial and narcissistic traits.   Because they are still narcissists, they are oversensitive to criticism, but unlike garden-variety narcissists, they have no conscience or sense of right from wrong.  Or if they do, they don’t care.  They are sadistic and enjoy the suffering they cause others.   They go out of their way to hurt others, because hurting others makes them feel good.    If you cause a malignant narcissist to suffer narcissistic injury, they will react in very antisocial ways.  They are spiteful and seek revenge when they are hurt.  They also tend to be extremely paranoid and act out against others pre-emptively to prevent injury.  A garden variety narcissist, when injured, may annoy you to death, demand reassurance, project, gaslight, or disappear, but won’t deliberately seek revenge just to hurt you.   They are broken people desperately trying to keep their false self intact but are almost always unaware of this.  They may be paranoid, but not to the point of pre-emptive attacks to avoid narcissistic injury.   Malignant narcissists also like to create chaos and tend to thrive in chaotic environments, where other people (including non-malignant NPDs) would just fall apart.  They may not be criminals or do anything against the law, but they like to cause upheaval, chaos and suffering.

Non-malignant narcissists are manipulative and dangerous too, but they don’t go out of their way to hurt others.   They are probably unaware of the pain they cause other people, and just think they are always right and that others are just extensions of themselves.   They may truly believe they are doing the right thing, truly believe you are at fault, or truly believe the person they are victimizing is really victimizing them.   Some non-malignant narcissists, if they ever become aware of the harm they cause to others, suffer from feelings of guilt and shame and even remorse.    Not so with malignant narcissists, who are usually fully aware of the pain they cause to others and derive sadistic pleasure from it.

Malignant narcissists, outside of an act of God, probably can never get any better.  They will never voluntarily enter therapy because they don’t think they have a problem; it’s everyone else who has the problem and deserves their wrath.   If there are evil people in the world, people with malignant narcissism would fit the bill better than anyone else.  Non-malignant narcissists may be extremely disordered, but they aren’t evil.  They may have moments of humanity and even emotional empathy.  They may be very difficult to cure (NPD is probably the most difficult personality disorder to cure outside of ASPD) but sometimes they voluntarily enter therapy, especially after a great loss.  A malignant narcissist would never be caught dead in a therapist’s office.